EP1935449B1 - Fil électrique tressé - Google Patents

Fil électrique tressé Download PDF

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Publication number
EP1935449B1
EP1935449B1 EP07024642A EP07024642A EP1935449B1 EP 1935449 B1 EP1935449 B1 EP 1935449B1 EP 07024642 A EP07024642 A EP 07024642A EP 07024642 A EP07024642 A EP 07024642A EP 1935449 B1 EP1935449 B1 EP 1935449B1
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EP
European Patent Office
Prior art keywords
strands
polymeric
conductor
lead
strand
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EP07024642A
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German (de)
English (en)
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EP1935449A1 (fr
Inventor
John M. Swoyer
Richard M. Farrell
Brian K. Farrell
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Greatbatch Ltd
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Greatbatch Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551—Spinal or peripheral nerve electrodes

Definitions

  • the present invention is related generally to medical electrical leads. More specifically, the present invention is related to implantable electrical leads. The present invention may find use in implantable neurological devices, cardiac devices, as well as many other devices.
  • Implantable leads having externally exposed ring or band electrodes can be used to deliver electrical stimulation to surrounding tissue and/or to sense electrical energy produced by the surrounding tissue.
  • Such leads are often implanted, for example, within the epidural or intrathecal spaces of the spinal column, along peripheral nerves, within the brain, and about the heart. Electrical stimulation of the spinal cord has been shown to be effective in relieving intractable pain in some patients. Such electrical stimulation can reduce or eliminate the use of pain relieving drugs. Examples of some leads may be found in U.S. Patent Nos.: 6,721,604 ; 6,981,314 ; 6,216,045 ; and 5,483,022 .
  • One such lead is formed of polymeric material, for example, polyurethane or silicone.
  • the lead can be nominally 1 mm in outer diameter and about 20 cm in length.
  • a typical lead may have a series of electrodes formed as bands or rings disposed in a spaced apart relationship in a lead distal region.
  • the distal region of the lead can be introduced, for example, into the epidural region for use in stimulation of the spinal column.
  • the lead proximal region may have a corresponding set of band or ring connectors or terminals, one for each corresponding electrode in the distal region. Each proximal region terminal can thus be connected to one distal electrode in a typical configuration.
  • the terminals can be used to couple the proximal end of the lead to a lead extension, which can in turn be coupled to an implantable pulse generator (IPG).
  • IPG implantable pulse generator
  • the lead extension can provide added length to extend the reach of the lead to a more distantly placed IPG. In some embodiments, the lead extension is between about 20 and 50 cm in length.
  • the lead typically has a lumen extending from the proximal end through to the distal region, with the lumen being dimensioned to accept a stiffening member or stylet.
  • the lead commonly formed of a polymeric material and being very small in cross section, is typically very floppy and not pushable. With a stylet or stiffening member inserted, the lead gains the needed pushability, and can be advanced into and up the spinal column to the desired location.
  • Small size, in particular, small outer diameter, is desirable for nerve stimulation leads.
  • a small profile is less intrusive and may be easier to deliver. Some peripheral nerve stimulation therapies would benefit from small profile leads.
  • Flexibility is desirable for both ease in delivery and for a more comfortable patient experience, as the patient may be aware of a stiffer implanted lead. A long flex life, the ability to survive a large number of lead flexures over the expected lead lifetime, is also desirable. Some cardiac leads are subjected to flexure with every heart beat. Peripheral nerve stimulation leads may be flexed and twisted with the patient's movements.
  • Spinal cord stimulation leads include several, often eight, conductors.
  • the conductors are often not arranged haphazardly.
  • a straight or coiled cable of conductors is often used. Issues arise that relate to the orientation and spacing of the conductors as they tend to float inside the lead body tubing. As the conductors float and potentially cross each other, flex life can be negatively impacted.
  • the document US-A 6,213,995 discloses a flexible tubing which includes a wall provided with a plurality of braided elements forming a braid within the wall of the tube.
  • the structural elements preferably provide a degree of torsional stiffness, kink resistance, or luminal rigidity to the catheter which is different than would otherwise be provided solely with one or more signal transmitting elements.
  • the tubing wall is preferably a cross-linking polymer, such as polyimide matrix.
  • one or more layers of the polymer are coated on a mandrel and permitted to cure to form an inner layer of the tubing.
  • the braid is then woven about the inner layer.
  • one or more layers of the polymer are coated over the braid and inner layer and permitted to cure to form an outer layer of the tubing which preferably forms a cross-linked and adhesive bond to the inner layer and provides a relatively homogenous structure.
  • Document EP-A 0 732 117 relates to a a catheter structure having an inner tube, a metallic mesh knit provided to surround an outer surface of the inner tube and an outer tube provided to cover an outer surface of the metallic mesh knit, the metallic mesh knit is formed by spiral lines, one of which is greater than the other in mechanical strength.
  • the present invention provides a lead according to claim 1.
  • FIG. 1 illustrates a neurological stimulation lead 20, similar is some aspects, to the lead illustrated in U.S. Patent Application Pub. No. 2005/0021119 .
  • Lead 20 can incorporate a multi-conductor cable according to the present invention.
  • Lead 20 has a distal region 24, a proximal region 26, and an intermediate region 28 disposed between the distal and proximal regions. In a preferred embodiment, the intermediate region is between the innermost distal and proximal electrical contacts described below.
  • a stylet entrance or insertion port 42 is provided in the intermediate region 28. In other embodiments, the stylet entrance may be absent or lie in the proximal end.
  • Lead 20 can be formed of a body or shaft 34 extending between a distal end 30 and a proximal end 32. Lead body 34 has an exterior surface or tubular side wall 36 and is preferably formed of a polymeric material, for example, polyurethane or silicone.
  • Lead distal region 24 may include a number of electrodes 38, which, for example, may be disposed concentrically about lead body 34 in a spaced-apart configuration. Electrodes 38 may also be described as electrical contacts or contacts. Electrodes 38 are normally adapted to be inserted into the human body and since they are externally exposed, can be used for neurological stimulation. One exemplary use of electrodes 38 is the stimulation of nerves within the spinal cord.
  • the proximal region 26 can include a number of externally exposed connector bands or connector rings 40 disposed in a spaced-apart configuration to serve as electrical contacts or terminals. Electrodes 38 and connectors 40 may be formed of platinum and/or iridium. The connectors 40 are used for connecting the lead 20 to a lead extension to extend the effective length of the lead or they may directly couple lead 22 to an implantable pulse generator.
  • Electrodes 38 and connectors 40 can be coupled to each other in a one-to-one arrangement.
  • the distal-most electrode is coupled to the distal-most connector
  • the second-to-distal-most electrode is coupled to the second-to-distal-most connector
  • the electrodes and connectors can be coupled through conductors extending between them.
  • the conductors are embedded within the lead while in other leads, the conductors lie within lumens extending the length of the lead.
  • FIG. 1 also illustrates a stylet 50 that includes a shaft 56 extending between a distal tip 52 and a proximal end or handle 54.
  • the stylet 50 is typically dimensioned to be slidably received within the stylet entrance 42 and a lumen extending distally toward distal region 24.
  • the lead 20 can be varied in outer diameter and length to suit the application for which it is intended.
  • the lead 20 has a total length of from about 5 cm and about 150 cm.
  • the lead 20 has an outer diameter of less than about 1 mm and a total length of from about 10 cm and 150 cm.
  • the lead length between stylet entrance 42 and distal end 30 can vary as well.
  • the distance from stylet entrance 42 to the distal end 30 is less than 50 cm, preferably less than 30 cm, and most preferably less than about 20 cm.
  • the stylet 50 preferably has a length adapted to approximately match the length between stylet entrance 42 and the distal end 30.
  • the stylet 50 preferably has a shaft outer diameter of less than about 1.27 mm (0.050 inches), more preferably less than about 0.51 mm (0.020 inches), and most preferably less than about 0.25 mm (0.010 inches).
  • FIG. 2 illustrates one embodiment of the invention in a multi-strand cable 110 including an insulated conductor strand 100, a first polymer strand 101, and a second polymer strand 102.
  • the first polymer strand 101 is under (inside of) the second polymer strand 102 in front and over (outside of) the second strand 102 in back.
  • the two polymer strands 101, 102 cross in front and in back, with the in-front crossings indicated by reference numerals 104 and 106.
  • strand refers to the elongate members which are braided (can be used to form a braid), and which may be a cable, a bundle, a twisted cable or bundle, a filar or group of filars, etc.
  • Insulated conductor 100 is oriented substantially longitudinally with the longitudinal axis of the multi-strand cable 110, and passing alternatively under and over the polymer crossing regions 104 and 106. In this example, insulated conductor 100 passes over crossing regions 104 and under cross regions 106. In this way, a longitudinal or linear "wave” is imparted to the insulated conductor 100. This provides an increased flex life to the insulated conductor.
  • Conductor strand 100 may be referred to as a zero degree, warp or triaxial, fiber or strand.
  • the two polymer strands 101, 102 are braided differently.
  • multiple conductors are included by modifying the braid pattern.
  • another such zero degree conductor is woven in and out of the braided polymer strands.
  • the woven braid may be inserted in a lead body tubing.
  • FIG. 3 illustrates another multi-strand cable 120 having a central longitudinal axis 122, a first insulated conductor 123, a second insulated conductor 125, a first polymer strand 124, and a second polymer strand 126.
  • the first conductor strand 123 and the second conductor strand 125 do not directly cross each other and each has a substantially coiled shape. This forms an essentially coiled structure within the braid which imparts increased flex life to the conductors.
  • the braided polymer strands maintain the overall configuration.
  • the multi-strand cable 120 represents a 2x2 diamond braid, where the insulated conductors 123, 125 are wound in a first direction (e.g. clockwise) and the polymer strands 124, 126 are wound in a second, opposite direction (i.e. counter-clockwise).
  • This 2x2 diamond braid, as well as 1x1, 3x3, 4x4, 8x8, etc diamond braids are explicitly within the scope of the invention.
  • the conductors 123, 125 run side by side, so they do not cross other conductors, but only polymer strands 124, 126. In this way, the conductors 123, 125 do not rub up against each other, which could lead to a short. Since the braid maintains this configuration, not as much stress must be placed on the conductors 123, 125 in order to maintain them in the desired shape.
  • FIG. 4A is an illustration of another embodiment of a multi-strand cable 200 according to the invention.
  • FIG. 4B is a photograph of embodiment 200.
  • the cable 200 is formed around a mandrel 220 running along the central longitudinal axis thereof.
  • the cable 200 includes a first insulated conductor strand 211, a second insulated conductor strand 212, a third insulated conductor strand 213, and fourth insulated conductor strand 214.
  • the insulated conductor strands 211, 212, 213 and 214 are each formed of seven twisted wires, each wire being formed of seven twisted filaments of a metallic construction.
  • the filaments are made of stainless steel, but could be any metal or metal alloy, including platinum, platinum/iridium, MP35N, silver cored MP35N, etc.
  • the insulated conductors have a polymer outer layer, for example an ETFE or other fluoropolymer coating. Any insulative material suitable for long term implant, including, PTFE, ETFE, polyimide, PEEK, polyurethane, silicone, etc., may be used.
  • the cable 200 also includes a first polymer strand 201, a second polymer strand 202, a third polymer strand 203, and a fourth polymer strand 204.
  • FIG. 4A Inspection of FIG. 4A shows that going from right to left, the first and second polymer strands 201 and 202 are adjacent to each other.
  • the polymer strands 201 and 202 both cross over the first conductor encountered (third conductor strand 213), then the first polymer strand 201 crosses under the next conductor encountered (the second conductor 212) with the second polymer strand 202 also crossing under the same conductor in the same region, then both polymer strands 201 and 202 cross under the next conductor encountered, then (not visible in FIG. 4A ) the first polymer strand 201 and the second polymer strand 202 both cross over the next conductor.
  • FIG. 5 illustrates a braid pattern 300 called a herringbone, regular braid pattern, in which one conductor strand passes under two polymeric strands then over two polymeric strands.
  • Five conductor strands 302, 304, 306, 308 and 310 pass from the lower left to the upper right while four polymeric strands 303, 305, 307 and 309 pass from the lower right to the upper left.
  • a conductor strand thus can pass through four different phases which repeat every four strands traveling from side to side, and from conductor to conductor.
  • Conductor strand 302 and strand 310 are in the same phase with respect to the same polymeric strand, for example, strand 303. In this embodiment, there is the same number of conductor and polymeric strands wrapped helically about the center axis.
  • FIG. 6 illustrates another braid pattern 330, termed a "diamond pattern, full load.”
  • five pairs of conductor strands 332, 334, 336, 338 and 340 pass from the lower left to the upper right.
  • Four pairs of polymeric strands 333, 335, 337 and 339 pass from the lower right to the upper left.
  • Each strand in a pair travels side-by-side in the same phase with its paired strand.
  • each pair of strands is in one of two phases, which repeat with every other pair of strands.
  • Conductor strand pairs 332 and 334 are both in the same phase with respect to polymeric strand pair 333.
  • FIG. 7 illustrates another braid pattern 360, referred to as a diamond braid pattern.
  • This pattern can also be referred to as a "diamond pattern, half.”
  • a conductor strand passes under one polymeric strand then over one polymeric strand.
  • conductor strands 362, 364, 366, 368 and 370 pass from the lower left to the upper right while polymeric strands 363, 365, 367 and 369 pass from the lower right to the upper left.
  • the strands are in one of two phases with adjacent strands being out of phase with respect to each other.
  • FIG. 8 illustrates another braid pattern 370 having strands 372, 374, 376, 378 and 380 passing from the lower left to the upper right. Strands 373, 375, 377 and 379 pass from the lower right to the upper left, each strand passing over two then under two.
  • An additional strand 371 is shown, which can be a conductor strand termed a triaxial fiber, a warp fiber, or a zero degree fiber.
  • the strands in the braid are polymeric strands and the zero degree strand is a conductor strand.
  • there is more than one zero degree conductor strand disposed about the braid for example 2, 3, 4 or more zero degree conductor strands.
  • the braid maintains the spacing from one conductor to another.
  • the braiding is performed over a mandrel, for example, a TEFLON ® coated mandrel.
  • Tubing can be placed over the braid.
  • the tubing and polymer may be formed of the same or similar materials, for example, a thermoplastic polymeric material.
  • the tubing having the braided polymer and insulated conductor strands within can be placed in a heat shrink tubing or other structure and a reflow operation performed.
  • the polymer strands and the outer tubing can become one, which may reduce the profile of the lead body.
  • the conductors and polymer strands are braided over a mandrel and the mandrel later removed, sometimes after further joining the insulated conductors and polymer strands with a reflow step.
  • a lumen may remain in such embodiments.
  • the strands are braided over a solid shaft, for example, a polymer or metal shaft, which remains after the braiding and any reflow.
  • the strands are braided over a tube having a lumen, which may remain after any reflow step to provide a lumen.
  • the polymer strands may be formed of a biocompatible material, for example, polyester. Some polymer strands are round and have about a 0.127 mm (0.005 inch) O.D., while the insulated conductors have about a 0.152 mm (0.006 inch) O.D. and include seven filaments.

Claims (20)

  1. Fil électrique médical implantable (110, 120, 200, 300, 330, 360, 370) comprenant :
    une pluralité de brins conducteurs électriques isolés (100 ; 123, 125 ; 211, 212, 213, 214 ; 302, 304, 306, 308, 310 ; 332, 334, 336, 338, 340 ; 362, 364, 366, 368, 370 ; 371) tressés avec une pluralité de brins non conducteurs (101, 102 ; 124, 126 ; 201, 202 ; 303, 305, 307, 309 ; 333, 335, 337, 339 ; 363, 365, 367, 369 ; 372, 374, 376, 378, 380, 373, 375, 377, 379) de telle manière que les brins conducteurs isolés ne se croisent pas directement les uns les autres ;
    dans lequel les brins conducteurs isolés (100 ; 123, 125 ; 211, 212, 213, 214 ; 302, 304, 306, 308, 310 ; 332, 334, 336, 338, 340 ; 362, 364, 366, 368, 370 ; 371) ont un revêtement polymérique et les brins non conducteurs (101, 102 ; 124, 126 ; 201, 202 ; 303, 305, 307, 309 ; 333, 335, 337, 339 ; 363, 365, 367, 369 ; 372, 374, 376, 378, 380, 373, 375, 377, 379) sont des brins polymériques, et
    caractérisé en ce que le revêtement polymérique et les brins non conducteurs polymériques sont au moins partiellement fusionnés ensemble.
  2. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 1, comprenant N brins polymériques, dans lequel N est au moins deux, et dans lequel les brins conducteurs isolés et les brins polymériques sont tressés ensemble pour former une structure tressée allongée.
  3. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 2, dans lequel le nombre de brins polymériques est au moins égal au nombre de brins conducteurs isolés.
  4. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon l'une quelconque des revendications 1 à 3, dans lequel il y a au moins quatre brins non conducteurs et au moins quatre brins conducteurs.
  5. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 2, dans lequel le nombre de brins conducteurs isolés est N et dans lequel les N brins conducteurs isolés (100 ; 123, 125 ; 211, 212, 213, 214 ; 302, 304, 306, 308, 310 ; 332, 334, 336, 338, 340 ; 362, 364, 366, 368, 370 ; 371) sont enroulés dans un premier sens horaire et les N brins polymériques sont enroulés dans un deuxième sens horaire opposé au premier sens.
  6. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 5, dans lequel une paire de brins conducteurs isolés adjacents inclut un premier brin conducteur et un deuxième brin conducteur, qui croisent les brins polymériques de telle manière que :
    a) le premier brin conducteur croise sous un premier brin polymérique et le deuxième brin conducteur croise sur le premier brin polymérique, puis
    b) le premier brin conducteur et le deuxième brin conducteur croisent sous un deuxième brin polymérique, puis
    c) le premier brin conducteur croise sur un troisième brin polymérique et le deuxième brin conducteur croise sous le troisième brin polymérique, puis
    d) le premier brin conducteur et le deuxième brin conducteur croisent sur un quatrième brin polymérique, où le premier, le deuxième, le troisième et le quatrième brins polymériques sont rencontrés dans cet ordre par le premier et le deuxième brins conducteurs.
  7. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 2, dans lequel les brins polymériques et les brins conducteurs sont tressés de telle manière que les brins conducteurs passent sur deux brins polymériques, puis sous deux brins polymériques d'une manière répétée, ou dans lequel les brins polymériques (101, 102 ; 124, 126 ; 201, 202 ; 303, 305, 307, 309 ; 333, 335, 337, 339 ; 363, 365, 367, 369 ; 372, 374, 376, 378, 380, 373, 375, 377, 379) et les brins conducteurs (100 ; 123, 125 ; 211, 212, 213, 214 ; 302, 304, 306, 308, 310 ; 332, 334, 336, 338, 340 ; 362, 364, 366, 368, 370 ; 371) sont tressés de telle manière que les brins conducteurs passent sur un brin polymérique, puis sous un brin polymérique d'une manière répétée.
  8. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 2, dans lequel les brins polymériques (101, 102 ; 124, 126 ; 201, 202 ; 303, 305, 307, 309 ; 333, 335, 337, 339 ; 363, 365, 367, 369 ; 372, 374, 376, 378, 380, 373, 375, 377, 379) et les brins conducteurs (100 ; 123, 125 ; 211, 212, 213, 214 ; 302, 304, 306, 308, 310 ; 332, 334, 336, 338, 340 ; 362, 364, 366, 368, 370 ; 371) sont tressés de telle manière qu'au moins deux des brins conducteurs sont adjacents l'un à l'autre et en phase l'un avec l'autre de telle manière que les au moins deux brins conducteurs adjacents passent sur et sous les brins polymériques de la même manière.
  9. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 2, dans lequel les brins polymériques (101, 102 ; 124, 126 ; 201, 202 ; 303, 305, 307, 309 ; 333, 335, 337, 339 ; 363, 365, 367, 369 ; 372, 374, 376, 378, 380, 373, 375, 377, 379) et les brins conducteurs (100 ; 123, 125 ; 211, 212, 213, 214 ; 302, 304, 306, 308, 310 ; 332, 334, 336, 338, 340 ; 362, 364, 366, 368, 370 ; 371) sont tressés de telle manière que les brins conducteurs passent sur deux brins polymériques, puis sous deux brins polymériques d'une manière répétée, et dans lequel des brins conducteurs adjacents sont déphasés l'un par rapport à l'autre de telle manière que la phase de conducteur est sensiblement répétée tous les quatre brins conducteurs.
  10. Conducteur médical implantable (110, 120, 200, 300, 330, 360, 370) selon l'une quelconque des revendications 1 à 9, dans lequel le fil a un diamètre extérieur de moins d'environ 4 mm ; et/ou dans lequel les brins conducteurs isolés ont un diamètre extérieur de moins d'environ ¼ mm ; et/ou dans lequel le fil a une longueur d'environ 5 cm à environ 150 cm.
  11. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon l'une quelconque des revendications 1 à 10, dans lequel le fil (110, 120, 200, 300, 330, 360, 370) a une première région d'extrémité (24) et une deuxième région d'extrémité (26) opposée à la première région d'extrémité (24), et dans lequel le fil (110, 120, 200, 300, 330, 360, 370) comprend en outre un premier ensemble d'électrodes (38) disposé dans la première région d'extrémité pour un contact avec une partie de corps vivant électriquement couplée aux brins conducteurs isolés, préférablement dans lequel un deuxième ensemble de contacts électriques (40) est électriquement couplé aux brins conducteurs isolés pour un contact avec un dispositif électrique.
  12. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 11, dans lequel la deuxième région d'extrémité est adaptée à une connexion avec une allonge de fil.
  13. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon l'une quelconque des revendications 1 à 12, dans lequel une enveloppe extérieure est disposée autour de la structure tressée allongée.
  14. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon l'une quelconque des revendications 1 à 13, incluant une entrée de stylet (42), préférablement dans lequel l'entrée de stylet (42) est à environ 20 cm à 50 cm d'une extrémité distale (30) du fil.
  15. Fil médical implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 1, comprenant :
    - un premier ensemble de brins polymériques (372, 374, 376, 378, 380) enroulés hélicoïdalement courant en parallèle les uns aux autres autour d'un axe commun de corps de fil ;
    - un deuxième ensemble de brins polymériques (373, 375, 377, 379) enroulés hélicoïdalement courant en parallèle les uns aux autres autour de l'axe commun de corps de fil, le sens d'enroulement dudit deuxième ensemble de brins polymériques étant contraire à celui du premier ensemble de brins polymériques ;
    - chaque brin du premier ou du deuxième ensemble de brins polymériques passant sur deux brins polymériques du deuxième ou du premier ensemble de brins polymériques et ensuite sous deux brins polymériques du deuxième ou du premier ensemble de brins polymériques ; et
    - une pluralité de brins conducteurs (371) courant en parallèle à l'axe de corps de fil tout en passant entre les brins polymériques du premier et du deuxième ensembles.
  16. Fil électrique implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 1, dans lequel les brins tressés sont orientés autour d'une lumière persistante.
  17. Fil électrique implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 1, dans lequel les brins tressés sont orientés autour d'un arbre.
  18. Fil électrique implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 1, dans lequel une couche polymérique est disposée autour des brins tressés.
  19. Fil électrique implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 1, dans lequel les brins conducteurs isolés (100 ; 123, 125 ; 211, 212, 213, 214 ; 302, 304, 306, 308, 310 ; 332, 334, 336, 338, 340 ; 362, 364, 366, 368, 370 ; 371) incluent au moins un brin conducteur s'étendant sensiblement longitudinalement le long du fil, se liant avec et se déliant d'avec les brins non conducteurs.
  20. Fil électrique implantable (110, 120, 200, 300, 330, 360, 370) selon la revendication 1, dans lequel le fil (110, 120, 200, 300, 330, 360, 370) a un diamètre extérieur de moins d'environ 4 mm, une longueur d'environ 5 cm à environ 150 cm, et les brins conducteurs isolés ont un diamètre extérieur de moins d'environ ¼ mm.
EP07024642A 2006-12-19 2007-12-19 Fil électrique tressé Active EP1935449B1 (fr)

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US9186499B2 (en) 2009-04-30 2015-11-17 Medtronic, Inc. Grounding of a shield within an implantable medical lead
US9259572B2 (en) 2007-04-25 2016-02-16 Medtronic, Inc. Lead or lead extension having a conductive body and conductive body contact
US9302101B2 (en) 2004-03-30 2016-04-05 Medtronic, Inc. MRI-safe implantable lead
US9463317B2 (en) 2012-04-19 2016-10-11 Medtronic, Inc. Paired medical lead bodies with braided conductive shields having different physical parameter values

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